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Anatomy > Anatomy - Outcome 15 > Flashcards

Anatomy - Outcome 15 Flashcards

1
Q

Overview of Oral Cancer

A
  • highly curable in the early stages
    -later stages of enlagement can spread to lymph nodes
    -the survival rate drops considerably
    -most oral cancers are discovered at late-stage
    -more deaths than cervical and uterine cancer and Hodgkin’s Disease
    -early detection is very imporant
    -responsibility of the dental team
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2
Q

Etiology of Oral Cancer

A
  • the exact cause is unknown
    -all cancers result from changes (mutations) in genes that control cell behaviours. Mutated genes may result in a cell that grows and proliferates at an uncontrolled rate, is unable to repair DNA damage within itself or refuses to self-destruct or die
    -takes more than one mutation to turn a cell cancerous
    -specific classes of genese must be mutated several times to result in a neoplastic cell, which then grows in an uncontrolled manner
    -when a cell does become mutated, it is capable of passing on the mutations to all of its progency when it divides.
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3
Q

Risk Factors for Oral Cancer

A
  1. Tobacco use is a prime factor
  2. Excessive alcohol
  3. Chronic Irritation
  4. Poor Oral Hygiene
  5. Overexposure to sunlight
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4
Q

Risk Factor for Oral Cancer - Tobacco

A
  • prime factor
    -drying of tissues leading to irritation
    -promotes keratin build up
    -heat and smoke cause cellular death and regrowth (mutations)
    -carcinogens in tobacco (benzene, formaldehyde, cadmium, urethane, lead, carbon monoxide)
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5
Q

Risk Factor for Oral Cancer - Excessive Alcohol

A

-chronic alcoholic persons have more lesions of the tongue and floor of the mouth than other locations in the oral cavity

-associated with combined tobacco use

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6
Q

Risk Factor for Oral Cancer - Chronic Irritation

A
  1. Keratotic lesions - hardened tissues
  2. Partial dentures - rough restoration
  3. Habitual cheek chewing
  4. Particularly in chronic alcohol and tobacco users
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7
Q

Risk Factor For Oral Cancer - Poor Oral Hygiene

A

-frequently associated with oral cancer

-disregard for personal hygiene

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8
Q

Risk Factor for Oral Cancer - Overexposure to sunlight

A

-higher risk of developing lip cancer

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9
Q

Clinical Appearance for Oral Cancer

A

-White areas (leukoplakia)
-Red Areas (erythroplakia)
-Ulcers
-Pigmentation
-Masses

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10
Q

Clinical Appearance for Oral Cancer - White Areas (Leukoplakia)

A
  1. Diffuse, filmy or well defined
  2. Ulcers or red patches within the white area
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11
Q

Clinical Appearance for Oral Cancer - Red Areas (erythroplakia)

A
  1. Red plaques or patches
  2. Not raised, within the mucosa
  3. Tiny areas of ulceration starting
  4. White leukoplakia surrounding areas
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12
Q

Clinical Appearance for Oral Cancer - Ulcers

A
  1. Always arouse suspicion
  2. History of lesion
  3. Palpate looking for hard swellings (low pain)
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13
Q

Clinical Appearance for Oral Cancer - Pigmentation

A
  1. Brownish to black coloration
  2. On oral mucosa
  3. Always should be investigated
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14
Q

Clinical Appearance for Oral Cancer - Masses

A
  1. papillary masses (may be ulcerated)
  2. other masses may occur below the normal mucosa (may only be found with palpation)
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15
Q

Where to look for Oral Cancer?

A

-Face and Neck
-Lips
-Buccal mucosa
-Floor of mouth
-tongue
-Hard and Soft Palate
-Arches and Tonsils

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16
Q

Where to look for Oral Cancer - Face and Neck

A
  1. Visually looking for changes in the skin (warts, ulcers, pigmentation)
  2. Asymmetry (tumors)
  3. lumps or bumps should be palpated and compated to the opposite side
17
Q

Where to look for Oral Cancer - Lips

A
  1. external vermillion border and mucosa of the inner lip
  2. the lip should also be palpated
  3. fissures, ulcers, hard keratotic areas, pigmentation
18
Q

Where to look for Oral Cancer - Buccal Mucosa

A
  1. Retract cheeks, inspect buccal folds and gingiva
  2. Retromolar pads and palpate the cheeks
19
Q

Where to look for Oral Cancer - Floor of Mouth

A
  1. Lift tongue to the roof of the mouth
  2. Palpate the posterior border of the tongue along the molars
  3. Wharton’s duct comon for leukoplakia
  4. Palpate with one hand under the chin and one pressing down the floor of the mouth
20
Q

Where to look for Oral Cancer - Tongue

A
  1. Protrude tonge, rotate left and right
  2. Check along “v” of the posterior region
  3. Palpation also required
21
Q

Where to look for Oral Cancer - Hard & Soft Palate

A
  1. Tilt head back
  2. Visually inspect for pigmentation changes and patches
22
Q

Where to look for Oral Cancer - Arches and Tonsils

A
  1. The patient says “ah” - be sure movement of the uvula
  2. Patches on tonsils
  3. Inspect arches for ulcerations
23
Q

Order of High-Risk Areas for Oral Cancer

A

-the lower lip
-the lateral border of the tongue
-the floor of the mouth
-the buccal mucosa
-the tonsils
the gingiva

24
Q

Most deadly aspect of cancer is…

A

its ability to spread or metastasize

25
Q

Progression of Cancer

A

Cancer cells initially group together to form a primary tumor. Once the tumor is formed, cells may begin to break off from this tumor and travel to other parts of the body. This process is metastasis. These cancer cells that travel through the body are capable of establishing new tumors in locations remote from the site of the original disease.

26
Q

Metastasis

A

Metastasis is a very complicated process that has yet to be completely understood. To metastasize, a cancer cell must break away from its tumor, invate either the circulatory or lymph system which will carry it to a new location, and establish itself in a new site

27
Q

2 Categories of Oral Cancer

A

*Lip Cancer and Intraoral cancer

-based on prognosis
-90% of all cancer is sqamous cell carcinoma
-arising from epithelial tissue

28
Q

Lip Cancer

A
  1. Painless, keratotic, white, crusting
  2. May feel hard and painless
  3. Good prognosis and generally do not metastasize
  4. Tobacco and sunlight as the main casual factors
  5. Treatment - surgery, sometimes readiation is required
  6. Basal cell carcinoma - common on face “lesion that won’t heal”
29
Q

Intraoral Cancer

A
  1. Most common on the tongue
  2. Painless until late stages
  3. Over 14 days and still not healing
  4. Small ulcers and plaques in the early stages
  5. Higher grade and more likely to metastasize than lip cancers
  6. The survival rate increases significantly with lesions less than 1 cm
  7. The survival rate increases significantly with lesions less than 1 cm
  8. Importance of early detection
  9. Treatment:
    -Surgery
    -Radiation therapy - xerostomia issues (caries)
    -Chemotherapy
30
Q

Other Malignacies

A
  1. Intraoral salivary gland malignancy
    -minor salivary glands
    -palate - firm, painless, growing mass
    -smoker’s palate - red, white lesions
    -Treatment - surgical and poor prognosis
  2. Malignant Melanoma
    -rare by highly lethal
    -dark brown-black spots on oral mucosa
  3. Bone Tumors
    -metastasis
    -spread of cancer from the oral cavity
    -result of developmental tumors or cysts
31
Q

Clinical Considerations for Oral Cancer

A
  1. Oral cancer screening protocols part of every visit and examination
  2. Everyone’s responsibility including the dental assistant
  3. Be aware of the patient’s history (family cancer, alcohol, tobacco use)
  4. Look for leions that “wont go away”
  5. Accurately record abnormalities for future comparasion of size and appearance
32
Q

Why Death Rate for Oral Cancer is High?

A

The death rate associated with this cancer is particularly high due to the cancer being routinely discovered late in its development. Often it is only discovered when cancer has metastasized to another location, most likely the lymph nodes of the neck

33
Q

Prognosis of Oral Cancer at later stage

A

The prognosis at this stage of discovery is significantly worse than when it is caught in a localized area. Besides the metastasis, at these later stages, the primary tumor has had time to invade deep into local structures

34
Q

Why Oral Cancer is Particulary Dangerous??

A

Oral cancer is particularly dangerous because it has a high risk of producing second, primary tumors
This means that patients, who survive a first encounter with the disease, have up to 20 times higher risk of developing second cancer. This heightened risk factor can last for 5 to 10 years after the first occurrence. The good news is, however; that the dental assistant, dentist, or doctor can see or feel the precursor tissue changes or actual cancer while it is still very small, or in its earliest stages

Because there are so many benign tissue changes that occur normally in your mouth, and some things as simple as a bite on the inside of your cheek may mimic the look of a dangerous tissue change, it is important to have any sore or discolored area of the mouth, which does not heal within 14 days, looked at by a professional

Anatomy (33 decks)

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